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At the time of diagnosis, approximately 16.5% of prostate cancer patients are metastatic. The main framework of metastatic prostate cancer treatment is androgen deprivation therapy, which is performed surgically or medically. The aim of this study is to evaluate the attitudes of medical oncologists and urologists about orchiectomy as androgen deprivation therapy.A total of 387 physicians working in the Departments of Urology (n=217) and Medical Oncology (n=170) were included in this descriptive study. Data were collected through an electronic survey.Only 7.5% of participants indicated that they offered surgical castration to their patients. Urologists preferred surgical castration more than oncologists for the treatment of metastatic castration-sensitive prostate carcinoma (P=.003). The reasons why medical oncologists preferred surgical castration less are that it is an invasive procedure, has risk of morbidity and mortality, high cost of hospitalization, and may cause deterioration of the patient's body image (P.05).This study showed that physicians were less likely to perform orchiectomy as an androgen deprivation therapy. Although the most important reason for this is the patient preference, the biased presentation of treatment options to patients, the lack of knowledge of physicians about orchiectomy, and the effect of the pharmaceutical industry should also be kept in mind.

Amaç: Koronavirüs hastalığı-19 (COVID-19) tüm dünyada üroloji de dahil olmak üzere bütün uzmanlık dallarını etkilemiştir. Pandemi döneminde üroloji pratiğinde genel ayaktan başvuru ve cerrahi prosedür sayılarında azalma görülmüştür. Bu çalışmada COVID-19 pandemisinin özellikle laparoskopik ürolojik cerrahi üzerine etkilerini incelemek istedik. Gereç ve Yöntemler: Üçüncü basamak sağlık kuruluşu olan yüksek volümlü 3 merkezdeki Üroloji kliniklerinde, pandemi öncesi Mart 2019 – Mart 2020 arasındaki bir yıllık dönemde laparoskopik cerrahi uygulanan hastalar (Grup 1) ve pandemi dönemindeki Mart 2020 – Mart 2021 arasındaki bir yıllık süreçte laparoskopik cerrahi yapılan hastalar (Grup 2) değerlendirildi. Bu kesitsel çalışmada hasta verileri hasta dosyaları kullanılarak retrospektif olarak incelendi. Bulgular: 241 hastanın 152’si Grup 1’de, 89’u Grup 2’deydi. Gruplar arasında cinsiyet ve yaş açısından farklılık izlenmedi. Gruplar arasında intraoperatif ve postoperatif majör komplikasyonlarda anlamlı farklılık saptanmadı (sırasıyla p=0,602; p=0,626). Pandemi döneminde uygulanan üroonkolojik cerrahi sayısı (n=63; %70,8), pandemi öncesi döneme kıyasla (n=81; %53,3) anlamlı olarak yüksekti (p, Objective: Coronavirus disease (COVID-19) has affected all medical specialties including urology all over the world. During the pandemic period, there has been decrease in the number of general outpatient and urological surgeries. In this study, we aimed to evaluate the effects of the COVID-19 pandemic on laparoscopic urological surgery.Material and Methods: The study was designed in Urology clinics in 3 high-volume centers, which are tertiary healthcare institutions. Patients who underwent laparoscopic surgery for 1 year between March 2020 and March 2021 during the pandemic period (Group-1) and patients who underwent laparoscopic surgery for 1 year before the pandemic (Group-2) and their complications were evaluated. This study designed as cross-sectional study and patient data were analyzed retrospectively using patient files.Results: Of the 241 patients, 152 were in Group 1 and 89 were in Group 2. There was no difference between the groups in terms of gender and age. There was no significant difference between the groups in intraoperative and postoperative major complications (p=0.602; p=0.626). The number of urooncological surgeries performed in pandemic period (n=63; 70.8%) was significantly higher than pre-pandemic period (n=81; 53.3%) (p

Amaç: Büyük ve kompleks böbrek taşlarının tedavisinde etkili ve güvenilir bir yöntem olan perkütan nefrolitotomi (PNL) ameliyatının en önemli aşaması akses sağlandıktan sonra uygun ve efektif bir traktusun oluşturulmasıdır. Bu amaçla Amplatz, balon ve Alken dilatatörler gibi farklı teknikler tariflenmiştir. Biz pediatrik PNL ameliyatlarında single step Amplatz dilatasyon tekniğinin etkinlik ve güvenilirliğini aşamalı Amplatz dilatasyon tekniği yapılan hastalar ile karşılaştırmayı amaçladık.Yöntemler: Bu çalışma retrospektif kohort çalışmasıdır. Son on yılda merkezimizde 72 pediatrik hastaya uygulanan 75 PNL ameliyatının verileri değerlendirildi. Single step dilatasyon tekniği (Grup 1, n:41) ile aşamalı dilatasyon tekniği (Grup 2. n:34) yapılan hastaların floroskopi ve cerrahi süreleri, taşsızlık ve komplikasyon oranları, ameliyat öncesi ve sonrası hematokrit seviyeleri ile kan transfüzyon oranları karşılaştırıldı. Bulgular: Gruplar arasında hastaların demografik verileri, ortalama taş yükü, operasyon süresi, hematokritte azalma, kan transfüzyonu ihtiyacı, taşsızlık oranı ve komplikasyon oranları açısından anlamlı farklılık görülmedi. Grup 1 ve Grup 2 medyan floroskopi süreleri sırasıyla 120 ve 220 saniye olarak saptandı. Single step dilatasyon grubunda ameliyat ve floroskopi süreleri anlamlı olarak daha kısa olduğu saptandı. Sonuç: PNL, çocuk taş hastalıklarında uygulanan güvenli ve etkili bir prosedürdür. Bu prosedürün tek adımlı dilatasyon tekniği ile yapılması çocuk hastaların daha az radyasyona maruz kalmasını sağlamaktadır., Aim: The most important stage of percutaneous nephrolithotomy (PNL), which is an effective and reliable method in the treatment of large and complex kidney stones, is to create a suitable and effective tract after the accessory is provided. For this purpose, different techniques such as Amplatz, baloon and Alken dilators have been described. We aimed to compare the efficacy and safety of single-step Amplatz dilatation technique with stepwise Amplatz dilatation technique in pediatric PNL patients.Methods: This is a retrospective cohort study. We evaluated the data from 75 PNL operations performed on 72 pediatric patients in our center within the last decade. The data from single-step dilation technique patient group (group 1, n: 41) and the stepwise dilatation technique patient group (group 2, n: 34) was compared in terms of durations of fluoroscopy and surgery, stone-free and complication rates, pre and postoperative hematocrit levels and blood transfusions rates. Results: There was no significant difference between the groups in terms of demographic data, mean stone burden, duration of surgery, decrease in hematocrit, blood transfusion rates, stone-free rate and complication rates. The median fluoroscopy durations of group 1 and group 2 were 120 and 220 seconds, respectively. Duration of surgery and fluoroscopy were significantly shorter in the single-step dilatation group Conclusion: PNL is a safe and effective procedure for pediatric stone diseases. Performing this procedure with a single-step dilatation technique ensures that children are less exposed to radiation.

Amaç: Kontrastsız bilgisayarlı tomografi (BT) kullanılarak, üriner sistem taşlarının Hounsfield ünitesi (HU) ölçümü ile, taşların dansiteleri hakkında bilgi verir. Bu çalışmada, pediatrik taş hastalığı olan hastalarda taş HU değerlerinin perkütan nefrolitotomi (PCNL) sonuçları üzerindeki etkileri değerlendirildi.Yöntemler: Bu retrospektif kohort çalışmasında, Ocak 2010 ve Aralık 2018 tarihleri arasında PCNL uygulanan 61 pediatrik hastanın kayıtları değerlendirildi. Hasta kayıtlarından tüm hastaların demografik verileri, taş özellikleri, peroperatif değişiklikleri, sonuçları ve komplikasyonları tarandı. Operasyon öncesi BT çekilen çocuk hastaların taş yapıları, HU değerlerine göre iki gruba ayrıldı: düşük HU grubu (HU ≤1000) ve yüksek HU grubu (HU >1000).Bulgular: 61 pediatrik hastaya toplam 65 PCNL operasyonu uygulandı. Tüm hastaların medyan taş boyutu 420 mm2 – 475 mm2 (78-2475), basit / kompleks taş oranı 36 (%55,3) / 29 (%44,6) idi. Operasyon öncesi BT kullanılan toplam 38 hasta incelendi. Hastaların 22'sinde HU değeri ≤1000 iken, 16'sında HU değeri >1000 idi. Düşük ve yüksek HU grupları karşılaştırıldığında, gruplar arasında işlem süresi, floroskopi zamanı, başarı oranları ve komplikasyon oranları açısından istatistiksel olarak anlamlı fark saptanmadı.Sonuç: Pediatrik popülasyonda uygulanan PCNL ameliyatı, büyük ve kompleks taşların tedavisi için etkili bir yöntemdir. PCNL'den önce BT kullanılarak değerlendirilen pediatrik hastalarda, taş HU değerlerinin PCNL başarısını etkilemediğini belirledik., Aim: The measurement of the stone densities of urinary system calculi in Hounsfield units (HU) using non-contrast computed tomography (NCCT) provides information regarding the composition and hardness of the stones. This study aims to evaluate the effects of stone HU values on the percutaneous nephrolithotomy (PCNL) outcomes in pediatric stone disease patients. Methods: In this retrospective cohort study, the records of 57 pediatric patients, who had undergone PCNL between 2010 January and 2018 May, were evaluated. Demographic data, stone characteristics, peroperative changes, outcomes, and complications were obtained from patient records. The patients were divided into two groups based on their HU values: the low HU group (HU ≤1000) and the high HU group (HU >1000). Results: A total of 61 PCNL operations were performed on 57 pediatric patients. Overall median stone size was 420 mm2 – 475 mm2 (78-2475) and simple/complex stone rate was (52.4%) / 29 (47.5%). A total of 38 patients were examined using NCCT prior to the operation. Twenty-two of the patients had an HU value ≤1000, whereas 16 had an HU value>1000. There were no statistically significant differences between the low and the high HU groups in terms of the duration of procedure, fluoroscopy time, success rates, and complications.Conclusion: PCNL surgery is an effective method for the treatment of large and complex stones in the pediatric population. We determined that in pediatric patients who were evaluated using NCCT prior to PCNL the stone HU values of did not influence PCNL success.

Aim: Bladder pain syndrome is a chronic disease with unknown etiology and treatment of the disease has not been clearly defined. Any curative treatment choice does not exist for bladder pain syndrome. Various medical treatment choices have been introduced but treatment is usually performed specifically and empirically. Alternative treatment strategies and/or treaatment combinations may be selected. In our study, we aimed to evaluate the treatment strategies and success for bladder pain syndrome.Material and Methods: The medical records of 47 patients diagnosed with bladder pain syndrome between January 2008 and June 2015 have been investigated retrospectively. Patients who have been treated first at our clinic and who have received amitriptyline, pentosan polysulphate PPS , hydrodystension HD , intracavitary dimethylsulphoxyde DMSO and intracavitary botulinum toxin BTİ injection treatment together with supportive treatment have been included to the study. Twelve patients who have not completed follow-up course following treatment and 9 patients who have received treatment before have been excluded. Patient satisfaction and higher than 50% decrease in visual analog score VAS have been accepted as treatment success.Results: Mean age of 26 patients was 42,8±10,2 32-59 . Five of 26 patients who have received conservative treatment and amitriptyline treatment gained benefit from treatment. Twelve of 26 patients have not received PPS treatment and 14 patients have received PPS treatment. Of these 14 patients, 3 of them have improved. HD treatment has been proposed to 11 patients, 3 of 7 patients who have received HD treatment have improved. Two of 4 patients who have received intracavitary DMSO treatment have gained benefit from the treatment. Two of 4 patients who have received intracavitary BTI treatment have gained benefit from the treatment. Eleven of 26 patients have not improved following any of the treatment strategies.Conclusion: Bladder pain syndrome is a chronic disease with worse patient compliance. Low success rates of different tretmant stages worsens the patients’ compliance to the treatment. Patient and clinician awareness for absence of curative treatment modality and knowledge for the fact that some symptomatic improvements mean an already won victory might increase compliance to the treatment., Giriş: Ağrılı mesane sendromu nedeni bilinmeyen kronik bir hastalıktır ve tedavisi iyi tanımlanmış değildir. Ağrılı mesane sendromu için küratif tedavi seçeneği yoktur. Çeşitli ilaç tedavileri vardır, ancak tedavi genellikle özgün ve ampirik olarak uygulanmaktadır. Tedavi alternatifleri ve/veya tedavi kombinasyonu denemek gerekebilir. Çalışmamızda kliniğimizde uygulanan Ağrılı mesane sendromunun tedavi basamaklarını ve başarısını irdelemeyi amaçladık.Gereç ve Yöntemler: Ocak 2008-Haziran 2015 tarihleri arasında kliniğimizde İnterstisyel sistit/ağrılı mesane sendromu tanısı konulan 47 hastanın kayıtları retrospektif olarak incelendi. İlk tedavisi kliniğimizde başlanan, destekleyici tedaviye ek olarak Amitriptilin, Pentosan Polisülfat, Hidrodistansiyon, İntrakaviter Dimetilsülfoksit ve İntrakaviter botulinum toksin enjeksiyonu tedavisi uygulanan hastalar çalışmaya dahil edildi. Tedavi sonrası en az 1 yıllık takip süresini tamamlayamayan 12 hasta ve daha önce tedavi almış 9 hasta çalışma dışında bırakıldı. Tedavi başarısı olarak hasta memnuniyeti ve/veya visüel analog skorunda VAS %50’den fazla düşme kabul edildi.Bulgular: 26 kadın hastanın ortalama yaşı 42,8±10,2 32-59 idi. Tedavi yapılan 26 hastanın 5’i konservatif tedavi ve Amitriptilin tedavisinden fayda gördü. 26 hastanın 12’si PPS tedavisine geçmedi, 14 hastada PPS tedavisi uygulandı ve 3 hasta PPS tedavisinden fayda gördü. 11 hastaya HD önerildi, HD uygulanan 7 hastanın 3’ünde başarı sağlandı. İntrakaviter DMSO uygulanan 4 hastanın 2’si tedaviden fayda gördü. İntrakaviter BTİ uygulanan 4 hastanın 2’si tedaviden fayda gördü. Toplam 26 hastanın 11’i hiçbir tedaviden fayda görmedi.Sonuç: Ağrılı mesane sendromu tedavi uyumu kötü kronik bir hastalıktır. Tedavi basamaklarının düşük başarı oranları, hastaların tedaviye uyumunu zorlaştırmaktadır. Tedaviye yönteminde hem hasta hem de hekimin kesin iyileştirici tedavi olmadığının farkında olması ve tedavi sırasında bazı iyileşmelerin zaten bir zafer olduğunun bilinmesi tedavi uyumunu artırabilir.

Ongün, Şakir (Balikesir Author), Objective To present a nation-wide analysis of the workload of urology departments in Turkey week-by-week during Covid-19 pandemic. Methodology The centres participating in the study were divided into three groups as tertiary referral centres, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9-March-2020 and 31-May-2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated, also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019. Results A total of 51 centres participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the 3rd week of pandemics in state hospitals and tertiary referral centres; however, the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared, a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid-19 pandemic compared with normal life. Conclusions Covid-19 pandemic significantly affected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non-deferrable surgeries by urologists in concordance with published clinical guidelines.